Smiles n Spokes

It's here!  LJ's high-to-low chassis seat and frame for school arrived today.  There are still some missing pieces that were supposed to be ordered.  I'm waiting for their ETA but for now, the timing could not have been more perfect.  School starts in a week.  The school has a second frame so that when the actual wheelchair base arrives, LJ will eventually be able to take the entire fixture onto the school bus and they will have several different options for him. The wheelchair portion is compatible with the seat we just got, and  LJ will be able to work on self-propelling.

(Shh, don't tell Nate. )The first thing Noodles did when he sat in his new chair was saddle up to Nate's lego table and he gave it a good swipe!

Who Am I?

I believe this bears repeating...

Fair

Once upon a time, Emily and I took both boys to the fair.  We met with my brother and sister-in-law and their adorable baby, Parker.  We saw the baby piglets and baby cows in the 4-H building, we made turkey callers out of dixie cups and cocktail straws...but alas did not get the turkeys' attention and Nate had a mutant ninja turtle painted on his cheek.  Nate made a chia-head out of stockings and wheat grass seeds.  LJ had his hand painted with his on-again-off-again favorite, Elmo.  Parker promptly fell asleep in his stroller.

And then there were the rides.  Emily took Nate on a super fun ride.  She also took LJ on the aptly-named ride, Wiggle Wurm.  Emily is a such a wonderful caregiver.  She takes such good care of our family.  We have been blessed with her selfless acts of service, listening ear and she seems to always look outside her own needs to help out with the boys.  Case in point, promptly after the above ride with Nate, it was Emily who looked green and a little woozie; not Nate as we had expected.
 
And then there was the food.  Emily tried a giant turkey leg.  It could have fed a couple Vikings.  She walked around with it, brought the leftovers on the car ride and it still isn't finished as of today.  Nate cooled off with an Italian ice- sweetened with a most unnatural, artificially colored sugar water.  LJ got to try out a terriyaki chicken on a stick and some lemonade (one of his favorites!).  We narrowly avoided the fried butter, thank goodness.  Although I hear it is tasty. In hindsight maybe that would help LJ gain some much needed weight!

LJ getting Uncle Dan to escort/protect us through the fairgrounds

In lieu of cotton candy, Nate decided he wanted to play the ping-pong-in-a-fish-bowl game. No duck pond games for him. Lucky him!  We were guaranteed by the carnie that he would win something. Well, so no giant banana plush toy as a prize. It appeared to me that the lip of the bowl was too small to fit their ping pong balls, so we were the proud new owners of a consolation prize:  three betta fish.  Thank you very much (can you hear the sarcasm here).  And this is when it is not the story you think it is.  He fretted over them, naming each one Superman, Batman and Evil Robot.  He insisted that we needed to buy them a bigger tank other than the fish bowl we had. We settled for aquarium rainbow gravel.  He woke me up the first morning at 6am!@#$#$%% asking if it was time for him to feed them again.  Within the first 24 hours, two out of the three fish have gone on to better seas.  Nate was greatly saddened by this event & he may need therapy when he's older.

Hi Uncle Dan and Aunt Anne! We miss you and baby Parker.

City Slicker

LJ had therapeutic riding this morning.  He was not afraid to tell everyone how he'd rather be eating applesauce and graham crackers.  Ms. V, our therapist, had to review the schedule with him multiple times.   First ride Lee Roy the horse. Then snacktime. He got to feed this lovely 2,000 pound creature an apple at the end of his session.  Big horse, Lee Roy, was really a gentle giant though.  One of the exercises involved big yellow dice, that LJ would hold at midline with both hands and let drop to the ground.  Whatever number it landed on, was how many steps he and Lee Roy could advance farther. LJ had to practice some speech by trying to give Lee Roy the "walk on" command when it was time.  It really takes a lot of core strength, trunk control and neck control to keep from doing the head bob jello neck. His body, as you can see from the video, is trying to acclimate with each shift in weight from the horse's gait.  Interestingly enough, he can keep his balance when he wants to tell me the sign for "eat".  All 27 pounds of him...on a 2,000 pound animal.  It's incredible.

Back in the Saddle_LJ August 2011 from Jenn S on Vimeo.


City Slicker_LJ (almost 3) and Lee Roy August 2011 from Jenn S on Vimeo.
It's also been awhile since I checked in.  LJ had a weight check regarding his tube weaning.  Despite the feeling that he eats enthusiastically, he hasn't gained any weight in 6 weeks.  We're at a standstill at 12.22 kg and 91 cm.  It sort of makes sense, since he was always being force fed, I mean tube fed, whatever the prescribed bolus amount was whether or not he had a full-feeling.  I don't think he was ever at his natural weight. Another contributing factor is all his activity.  He is a squirmy worm.  He kicks a lot, he tries to wriggle out of my arms, he can fold himself over to touch his shoes, completely over his legs when seated in his wheelchair.  So zero weight gain leaves us needing to supplement his oral intake with 200 extra calories a day.  We've added extra butter, oil, protein powder, pediasure, avocadoes and the like to his list of preferred foods.  We'll have another weight check in 6 weeks.  We'll see.

We met with the neurologist.  The doctor feels like LJ's main focus should be therapy. No MRI at this point is going to yield any actionable information.  The area where LJ's brain suffered the most injury, is his basal ganglia.  Its hard to tell from it's location just how significant his body was impacted but there are so many signals going through this bundle that effect his nervous system.  We continue to intensify therapies and see whether he will have verbal output and the strength to walk or sit.  So, in a nutshell.  It wasn't a bad meeting.  Just wasn't the clarification I was hoping for.

We also met with a really awesome speech therapist/technology consultant.  She met LJ and I and worked with us on his iPad for communication.  We're trying to tap into helping him communicate easier and more effectively.  It was a productive meeting and she shared a lot of knowledge and cool cause and effect apps to work on with the lil man.  We're meeting again soon so I will devote an entire post to it later.

School starts soon.  We are still having meetings to discuss evaluations and do the early childhood intervention reviews before the transition to a new special needs program through the county. I'm trying to get a meeting to revise LJ's IEP for school.  We need to add things like oral feeding goals since at the time, he hadn't been weaned from the feeding tube.  Amongst many other things, we also need to allow for the assistive technology devices. I'm following up with the rehab equipment folks to check the status of the stander and chair we had fitted for LJ back in May.  And nope, it's still not in.  The orthotic body suit and glove to avoid another round of botox still isn't in either.  And so it goes, we wait.  We call.  We follow up.  We wait.  We are spent but we are fighters.  We are hopeful parents, grandparents, brothers and sisters, aunts, uncles and friends.  We are hopeful.

Words to Say What You Mean

Give sorrow words; the
grief that does not speak knits up the
over wrought heart
and bids it break.

:: William Shakespeare, Macbeth ::

Outtakes from Ithaca

We're playing catchup from an almost perfect weekend.  We had some sleep-aversions amongst the youngest family member & a bit more rainy weather than anticipated, but otherwise we all enjoyed spending quality time with our friends.  Here are some outtakes from the weekend's zip lines, happy hours, farmers market & lake fun.  LJ had a neurologist appointment today and I'll catch you up on that later- but in essence everything is going well.  Pictures for now.

It's That Time Again

It was just last week we were packing snacks and driving twelve hours straight through. Now we're packing and heading north, to the Finger Lakes. Another weekend with friends and family experiencing more summer fun. Sweet summer days filled with ripe, blueberry picking and hanging out by the bonfire roasting marshmallows. There is going to be a birthday party in the Children's Garden and a concert in Taughanock park and of course the want and need of some good chill time hanging by the lake. We'll also test all the eateries around Ithaca (LJ has to try the Lindsay and Shortstop- now that he is a fill-fledged eater it is wild to come back after a year of all that's happened.) & attempt to finish some crazy 1500 piece puzzle. That is happiness for ya. Strength is being gained in more areas then you could ever know.

Children

Summer Pleasures

Summer is fleeting, but we are thankful for a lot of things.  The kids have loved playing on the beach and in the pool with their cousins.  We've enjoyed having wine and chatting with my cousins, walking on the beach, a bonus visit from my mom + dad, yoga and plenty of raucous family meals.  Some people say that what you love to do as adults in life, oftentimes were big (but perhaps forgotten) parts of who we were as children growing up.  We're so, so happy to make the most of the season with family and friends. Hopefully, the boys will carry these memories with them into their adulthood and forever.

Sun, Sea n Sand

Vacation is on the brain. I've got to prep the bags, grocery shop for car snacks and head down to South Carolina for some fun in the sun. Summertime and the living is easy. Well not quite. The drive is long (12 hours of 95 torture) and painful. But worth it. Can't wait to see the aunt n uncle, cousins and mom + dad, hit the pool, the beach, bikerides and yoga! I'm planning to let the waves wash it all away (ergo the pesky medical problems and annoying appointments calendar).  Puzzles n boardgames, kids gone wild, making huge meals for the extended crew etc etc. I want to read and sleep, laugh, ride bikes on the beach, and sleep and read some more. It is great fun for the entire family. Have a good week all!

Quote of the Day

Life is uncertain.  Eat dessert first.

~Ernestine Ulmer

via Fancy House Road

Happy Campers!

Here are some photos from Noodle's camp these past two weeks.  LJ made some great friends!  Of course all good things have to come to an end (camp was only two weeks)....at least until next summer.  As such, we will try to schedule some playdates with his new friends over the rest of the summer.  It really wouldn't have been possible without our fantastic caregiver, Emily, who enjoyed every sweaty minute of the camp as well.  Big shout out for all your help!

And here's big brother Nate, playing in a sprinkler.  Sorta wish I had the perfect music to play in the background...but this footage is just full of awesomeness.  These memories make me realize how happy the boys are.  It's definitely summer, but the days are flying by!  Enjoy.

Get In My Belly!

It's not a tree house!  They're broccoli trees!  Lewis tried them the other night and Mikey liked it (sans the wood picks).  He signed for more.  He thought it was funny that I asked him if he wanted to eat the trees.  The broccoli is from our farm share and the only thing I doctored it with was butter and a squeeze of lemon.  I figure the more butter the better.

LJ's been drinking fluids much more successfully too- perhaps we can attribute his new-found skill to the heat wave we've had.  He is particular about the vessel- it has to either be a stemless wine glass (that's how we roll) or his juice bear (think honey bear but obviously not honey-thick liquids).  So now the only thing LJ is receiving via his Gtube is approximately 120 ml of water! Go Lewie go!!

The Fourth

Let's get the BBQ started.  For those of you in the states, I hope you all have a great weekend with family and friends.

Be Still My Heart

I will never again take for granted the luxury of being able to speak easily and verbally what is on my mind.  It tears me apart that LJ cannot speak.  I tear up sometimes because I know that Noodles is frustrated beyond belief.  There is an eminent fear that he will be misunderstood and most of all unheard.  He has a definite opinion about what he wants to do, which food he wants to eat, which book to read or which clothes he wants to wear.  He is becoming more proficient with his iPad equipped with Proloquo2go but has not shown quick enough progress to ease the worry.  If something is too loud he expresses his displeasure by crying.  If I leave the room and he is upset, again, he voices his discontent by crying.  Noodles understands but he cannot respond.  Clearly, my achingly, beautiful child is a smart kiddo.  He's a hard worker yet his muscles give up and I love him and I ache for him.  And I feel guilty.  

Most of the time I can read his signs or movements pretty well.  Sometimes, though, he gets mad and can't muster a sound so he bucks backward and arches his back or throws himself forward in his wheelchair.  He can do some modified signs, but sometimes his lips move and there's no sound.  He watches our lips and tries to form the shape with his mouth only to come up empty-handed.  If we could just find a way to tap into his thoughts and desires...I listen with my heart and I am ashamed that I am inept at translating his cues but I still fantasize about how the words will sound.

That's where apraxia comes in.  It's entire diagnosis name is "childhood apraxia of speech" or CAS.  You can read the full NIH description for apraxia here.  But the short version is this: tell tale signs of apraxia are faulty speech motor planning and programming.  It is strongly based on neurological deficits or traumatic injury. LJ had major damage to his basal ganglia at birth, not that I know how to read the MRI's, but that's what the neurologist told us.  The basal ganglia is most notably the area in which people with Parkinson's disease lose the control of their bodily movements...just one of several neurological conditions that you may have heard about in celebrity news (read Michael J Fox and Mohammed Ali).  Unrelated to Parkinsons but no foreigner to medicine, Robert and Lynn Koegel are psychologists at UCSB (shout out to Uncle H!). They are distinguished clinicians and scientists who have done extensive research working with autistic children and are experts in helping children learn to speak. Five seems to be the magic age at which, if children will be able to speak, will have a much higher rate of success in the mainstream.  

Practice, practice and more practice.  We have two more years before we age out.  We are engaged in intensive speech therapy and have been since we began services through our early intervention program when LJ was 4 months old.  LJ has 4 hours per week of speech therapy with a PROMPT certified speech and language pathologist. He also has had countless hours of homework practiced in the home, at school, in other therapy sessions, in the grocery store and in everyday life.  I have sat on the other side of the two-way mirror while Lewis tries and tries as hard as he can to do what the SLP asks of him to no avail.  I have broken down in tears.

So as you can tell, I have been feeling a bit down.  But then today LJ's amazing speech therapist, Danielle, wrote me an email that quickly cheered me up."Also....last week...I forgot to tell you.  I was PROMPTing a word on him ...I think "up".  I did it several times to show him how.  He put his hand on my hand and pushed it away while nodding his head no.  Then spontaneously said "me".  Then he attempted to produce the word by himself. That was pretty cool!"

And that was indeed pretty cool.  In other news, the boys started camp on Monday.  Each are off to a great start- albeit exhausted by evening's onset.  Full days of water play, outdoors, sunshine, fresh air and making new friends.  While they're off gallivanting at camp, I've had a little free time on my hands to tackle some extra-curricular classes and feed my soul.  What is not to love?

Look Who's Cookin'

LJ is doing really well.  Markus, Jeni, Josh and I have all been doing the happy dance!  LJ gained weight from the last visit.  He's not quite gaining 5 grams a day as the nutritionist would like.  But he is up from 12.13 kg to 12.22 kg which roughly translates to 26.88 lbs.  On a regular growth chart this means he is in the 20%. We don't have to go back for six weeks.  In the meantime we will come up with a plan for further water reduction via gtube over the next week.

Big Blueberry Eyes_LJ Cookin' June 2011 from Jenn S on Vimeo.

Our Little CSA Harvest

School is out + our CSA farm share began a few weeks ago. This week's loot included blueberries, kale, scallions, scapes, broccoli, lettuce, cabbage, cucumbers, zucchini and squash. I've been using the Vitamix blender to get LJ's zucchini and squash all liquified so I can feed it to him.  Mikey likes it! I made some vinaigrette (same recipe as last year) for salads and marinades using the scapes. I've also made some pumpkin bread which LJ insists be dipped in applesauce but otherwise is able to eat it no problem.  I plan to make some blueberry muffins tomorrow!  I can't tell you what a tremendous emotion rushes over me when I realize LJ can experience and enjoy these summer nuances. Summer is fun now that he can have seasonal favorites like a popsicle, watermelon or lemonade.  Noodles loves to eat. That is a beautiful thing.

I'm loving every minute of it.  And guess what?  News flash:  LJ has learned to drink from a cup- its only about 1/2 ounce at each meal but it's a start.  He is only receiving 180 ml of water now via gtube to insure that he isn't dehydrated.  That's it, people, 180 ml.  That's down from 480 ml of water.  We've been most successful with water at this point, but we're slowly sneaking in some V8 Splash Fusion for extra kicks and giggles:) It's more challenging on the communication-front.  He grunts and makes some noise (and will not give up) until we realize that he wants a drink.

We play a fantastic game of charades at each meal time just to figure out what LJ prefers.  When he likes to eat, he automatically asks for more graham crackers and more applesauce...or cookies depending on his mood.  Drinks are so brand new that we are still trying to figure out which modified sign works best.  The sign for juice is fingers tapping the mouth gently or the letter "j" downward in the shape of a j.  LJ can sign "eat" no problem which is one hand placing the food in his mouth.  This is very, very close to the sign for water.  The sign for water is wiggling open fingers up and out from your mouth.  I've been trying to get LJ to use the sign for drink which is a simple. natural gesture for drink. His dystonia is too severe though, and he isn't able to complete these gestures even if it is trying with his functional, left hand and arm.

Hopefully he will be feeding & drinking 100% independently of his tube.  I'm in awe.

We have our weigh-in and check up at the GI office manana.  I'm a little nervous at the possible outcomes...but I am trying to remember something Jeni told me.  LJ is calling the shots- and it's important to remember that whatever weight he might be compared to...it is only the typical weight for his age and height.  LJ is far from typical; and he can't be pegged to a growth chart because it wasn't easy for him to jump over the tube weaning hurdle. We can't expect him to be his tube-fed weight; that just wasn't his norm...it was a consequence of being tube-fed whatever that allotted protocol prescribed. Oh, I really want things to go well so we can take out this button.  Think happy thoughts for us.

Still Climbin'

Mother to Son
Well, son, I'll tell you:
Life for me ain't been no crystal stair.
It's had tacks in it,
And splinters,
And boards torn up,
And places with no carpet on the floor—
Bare.
But all the time
I'se been a-climbin' on,
And reachin' landin's,
And turnin' corners,
And sometimes goin' in the dark
Where there ain't been no light.
So, boy, don't you turn back.
Don't you set down on the steps.
'Cause you finds it's kinder hard.
Don't you fall now—
For I'se still goin', honey,
I'se still climbin',
And life for me ain't been no crystal stair.

by Langston Hughes

Daddy-O

Dad-hood...well Josh gets all A's in our book. He practices CAYGO (Clean As You Go) when cooking, plays good and bad cop equally, tries to fix everything (with duct tape) and usually succeeds, is the most awesome teacher, loves Harry Potter as much as Nate, genuinely enjoys long car trips even with two whining toddlers, demonstrates a deep appreciation (well, almost) for his dear wife, never agrees to something without listening to what is being asked, says what he feels, can be humored with 5,000 piece Lego sets, laughs when we make a joke, makes life fun & is fiercely devoted.

Thank you Josh, you are a rock. Happy Father's Day!

Captain Personality

Pure Joy: Boat Pond in Central Park